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 NEWS
January/06/2007
Surgical treatment in
paraplegia survey:
Cross-anastamosis in paraplegia below D9 started to give
results. The last documented case operated 1 year ago in a patient from Israel came
to the clinic 3 weeks ago. ECS and EMG performed showed that there is
starting innervation of Th 11 and 12. The patient's lower limbs muscles
became bulky and he could contract the lower abdominal muscles and some
movements in the pelvic girdle. Crude sensation descended down to the
inguinal level both sides. If you are more interested in this topic,
click here!
March/08/2007
Tuberculosis of the
spine
In the last 2 years the incidence of
tuberculosis of the spinal column is becoming more frequent and having
different clinico-morphologic picture. This phenomenon is alarming sign
as the residual of the use of dirty bombs and several radioactive
materials in the surrounding dirty wars in the region. For demonstration
click here! and
here!
20-AUGUST-2007
SIEMENS Digital C-arm is implemented and
functioning in the Shmaisani hospital.
30-AUGUST-2007
The Inomed ISIS Highline neurophysiologic
navigation system start to work at the operating room.
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8. 28-FEBRUARY-2007
MUHAMED AHMAD BASALEEM 35 YEARS SECOND
RECURRENCE OF L5-S1 DISC RIGHT SIDED.
Anamnesis
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The patient was transferred
from the airport arriving from YAR directly to
Shmaisani hospital with agonizing right
sciatica. The patient was operated for
recurrence of huge disc L5-S1
27-October-2006
by me. The condition started 7 days ago, during
lifting heavy object with rotational element. |
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MRI performed 4 days ago
showing small extrusion of L5-S1
compressing the right S1 root causing the
agonizing sciatica, but with no neurological
deficit. |
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Considering that, he came
from far with agonizing sciatica, it was decided
to reoperate him. If he was a Jordanian citizen,
then it was better to wait for 1-2 months to see
if his extrusion shrinking, but due to
socio-economic reasons, he was sent to the
operating room. |
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The old incision was
refreshed and the right upper corner of the
lamina was widened for 2 mm and the scar was
removed, so as to expose the right S1 root.
During this, the extrusion came out, before
reaching the disc space. It was removed. The
right S1 root was explored further down and
inspection for more remnants revealed another
small fresh pieces, which were removed.
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The disc space was so narrow,
that only a tiny microswedish was able to be
introduced to the disc space. A small sized
pituitaries were unable to introduced to the
disc space. |
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The right S1 root hanging
free. Routine closure of the wound. |
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Immediate disappearance of
the right sciatica after surgery. |
Comments:
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In the previous second
operation, the expectation for recurrence was
minimal. But it happened 5 months later. |
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During the second surgery the
annulus was acceptable and the intradiscal space
was not violated. |
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If the disc space permit
further cleaning of the intradiscal material, it
is better retrospectively to perform cleaning,
because even if the disc space is narrow, there
could be pieces or fragments ready to slip
later. |
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It is still a dilemma , what
exactly better for the patient to perform.
Remove the extrusion without violating the disc
space, or perform meticulous cleaning of the
intradiscal space. |
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There are cases with 5-8 time
of recurrence and this phenomenon needs
solution. |
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